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Is Healthy Obesity a Myth?

Study found even with normal blood pressure, cholesterol and blood sugar levels, the obese had more artery plaque

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

WEDNESDAY, April 30, 2014 (HealthDay News) -- Can someone be obese and healthy? A new study and several experts say no.

An obese person who has normal blood pressure, normal cholesterol and normal blood sugar levels is still at risk for heart disease, Korean researchers report in the April 30 online edition of the Journal of the American College of Cardiology.

In the study of more than 14,000 men and women, aged 30 to 59, those who were obese had more plaque buildup in their arteries, putting them at greater risk for heart disease and stroke than people of normal weight, the researchers found.

"People have been trying to work out whether there is a group of people that are obese and healthy," said Dr. Rishi Puri, medical director of the atherosclerosis imaging core laboratory at the Cleveland Clinic and author of an accompanying journal editorial.

Puri noted that even if an obese person has normal blood pressure, cholesterol and blood sugar levels, those measures are likely to change over time and become abnormal, putting the patient at risk for heart disease, stroke and diabetes.

He also questioned the need, both in terms of research and patient care, of trying to define healthy obesity. "What are we trying to achieve? How does this help society?" he asked.

"We have an enormous challenge at a public health and individual level in dealing with obesity-related disorders. Being obese doesn't just affect the heart. Being obese means you're more likely to have joint disease, psychiatric disorders and cancers," Puri said.

He added that, over the next couple of decades, obesity and its consequences will be driving health care costs.

"Even if we find that these particular obese patients don't have a higher risk of heart disease in the short-term, what are the many other things obesity does to your body?" Puri said. "Are we going to ignore that?"

For the study, a team led by Dr. Yoosoo Chang, a professor at Kangbuk Samsung Hospital Total Healthcare Center, Center for Cohort Studies, in Seoul, scanned the hearts of 14,828 people who had no apparent risk factors for heart disease.

The researchers looked for buildup of calcium plaque in the heart's arteries, which is an early sign of heart disease. Calcium plaque is linked to atherosclerosis, which is a stiffening and hardening of the arteries.

The investigators found that the obese people had a higher prevalence of atherosclerosis of the heart arteries than the people of normal weight. If atherosclerosis is not managed, it can lead to heart attack and sudden cardiac death, among other heart conditions, the researchers noted.

"Obese individuals who are considered 'healthy' because they don't currently have heart disease risk factors should not be assumed healthy by their doctors," Chang said in a statement.

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